Targeting Genes: The Future of Cancer Treatment

Prostate Cancer Foundation

September 26, 2017

Let’s start with this: think of each person’s cancer as a unique locked door. Now imagine that with a simple test, we could find the right key to unlock that door and cure the cancer on the first try. This is the world of precision medicine, an emerging area of research that the Prostate Cancer Foundation (PCF) feels is the mechanism for finally unlocking the cancer problem.

So what does this mean for patients? Consider Mark Meerschaert’s experience. In a matter of weeks, Mark went from being an active on-the-go professor to someone who could barely walk; metastatic prostate cancer had come from nowhere and spread throughout his body.

As a respected mathematics professor and researcher, Mark ran the numbers. Men with widespread aggressive prostate cancer don’t live very long. Then, Mark did what we at PCF believe all men should do: He became his own best advocate. He connected with PCF-funded-scientist, Heather Cheng, M.D., Ph.D., an oncologist at the Seattle Cancer Care Alliance, University of Washington School of Medicine and Fred Hutchinson Cancer Research Center.

After a quick genetic test, Dr. Cheng identified that Mark has a “bad gene,” BRCA2, which runs in his family. The BRCA2 gene is most famous for increasing risk of breast and ovarian cancer in women – but recently, scientists discovered that it also increases the risk of prostate cancer in men.

Dr. Cheng immediately focused on this gene and offered a very different type of treatment – off-label use of a drug called olaparib, currently approved by the Food and Drug Administration to treat ovarian cancer, which has worked especially well in women with defects in their BRCA2 gene. Olaparib is a PARP inhibitor; it works by blocking a specific protein that certain cancer cells need to repair themselves. Now, olaparib and other PARP inhibitors are being studied in clinical trials for prostate cancer patients.

When Mark first began treatment with olaparib, bone scans revealed that the prostate cancer had spread all over his body, including tumors on his ribs, hips and legs. Cancer was taking away his ability to walk. He had to use a cane, then a walker and eventually a wheelchair. Just a few months after starting the experimental treatment, however, Mark slowly started walking again. Soon after, he was back to walking his dog a couple of miles every day.

Mark is one of the pioneering patients who benefited from gene-targeted treatment for prostate cancer that, as Dr. Cheng explains, “is tailored to the weakness of his cancer resulting from a specific gene mistake in that cancer, rather than just treating it the same as all prostate cancers.” This customized approach, finding the right key to unlock the door, is the hallmark of precision medicine.

The availability of treatments like the one that helped Mark walk again is thanks in part to clinical trials, researchers, and foundations like PCF that push the envelope of what’s possible.

“PCF research is increasingly revealing the genetic underpinnings of cancer across cancer types,” said Prostate Cancer Foundation President & CEO Jonathan Simons, M.D., “Family members must take the time to understand how genes that run in families can affect their health. This is not just for men – and not just for prostate cancer – but for all men and women and sons and daughters and grandchildren in the family. And it goes across all cancer types.”

Research is a process. There are no guarantees. But like the stock market, we invest in it because there is always progress over time. Mark says, “I can deal with that. I will be happy for what I get. I’m cautiously optimistic. I do feel like this is something pretty remarkable. My God, what if this had happened five years ago?”